Panniculectomy

A panniculectomy removes hanging fat and skin, typically after massive weight loss. It may be performed as a single procedure or combined with a tummy-tuck, depending on the patient's condition. Panniculectomy is different from abdominoplasty, in that abdominoplasty tightens the muscle as well as removes excess skin and fat, but a panniculectomy only removes excess skin and fat. A panniculectomy may also be performed with another abdominal surgery, such as a hysterectomy, or repair of the abdominal wall or hernia of the belly button.

The Best Candidate for Panniculectomy

Panniculectomy candidates typcially suffer from obesity, or have recently experienced significant weight loss, or suffer post-pregnancy issues with inordinate fat localized below the belly button.

Candidates may have fat extending as low as the knees, over the hips, and around the back. These conditions cause panniculectomy candidates to experience a host of health issues, including back problems, the breakdown of skin, rashes, ulcers, or skin disorders. These conditions may interfere with everyday life — walking, standing, or sitting may become very difficult.

The best candidates have stabilized their weight for at least one year. The candidate must be participating in a proper dietary and exercise plan. Candidates who have had the gastric bypass procedure should wait until one year after gastric bypass surgery or Lap-Band surgery, after the health problems associated with obesity have subsided.

The Panniculectomy Procedure

The panniculectomy is most often performed by a board-certified plastic surgeon. The location of the procedure is typically a hospital, although the procedure may be performed in an outpatient surgery center. Time in surgery may be several hours. The procedure is often performed under general anesthesia (while you are asleep) and requires a hospital stay, typically ranging from one day to one week.

An incision is made from the lower area of the sternum to the pubic bone. Another horizontal incision is made at the pubic area where the excess fat and skin can be delicately removed. The skin that remains is then pulled together and closed. Drains may be inserted that will require personal home care. Tape will be applied to the incision areas. Any essential repairs to the abdominal wall or hernia within the belly button can usually be made at the same time.

After Panniculectomy

Your surgeon will supply a complete postoperative instruction list to follow, to reduce the risk of complications. You will have to sponge bath. Your doctor may fit you with a medical garment to wear at all times (except during a sponge bath) until otherwise directed.

If drains were inserted, the drains will need to be emptied as instructed. Dressings will also need to be changed.

Pain, swelling and bruising can occur, which can be managed with medications and proper care. Keep in mind that normal activities cannot be resumed immediately. Restrictions include no exercise or lifting of 10 pounds or more. There cannot be any pressure placed on the abdominal area.

Complications and Risks

Complications are possible with any plastic surgery. The most common but infrequent panniculectomy complications include infection, bleeding, and excessive scarring. If these occur, notify your surgeon immediately.

Consult a Qualified Plastic Surgeon

A qualified plastic surgeon will help ensure that a panniculectomy is appropriate for your condition. The most qualified surgeons can also increase your odds of success and reduce the risk of complications.

It's important to choose a board-certified plastic surgeon from the American Board of Plastic Surgery who has extensive, specific panniculectomy experience, as well as expertise in all areas of abdominal plastic surgery. Board certification may not always guarantee the best results; however, board certification does require specific and rigorous surgical education and training, which can help you achieve a safe and successful outcome.

Here are some tips for consulting a plastic surgeon:

• Review the doctor's credentials, education, training, type of certification held, and number of times that the treatment has been performed in the practice.
• View before-and-after photos of patients with similar conditions who received a panniculectomy and alternative surgical options.
• Inquire about the method of the procedure and possible complications from surgery.
• Ask for a pre- and postoperative instruction checklist.

Costs

Panniculectomy costs include three fees: local or general anesthesia fees, facility fees, and surgeon's fees. Since the panniculectomy procedure is usually performed during an abdominoplasty, you only pay one anesthesia fee and one facility fee. Since your treatment will be customized to fit your needs, only an estimated range of costs can be given. Average total fees range from $8,500 to $10,000.

Insurance coverage for the cost of the panniculectomy varies. If the procedure is strictly for cosmetic reasons, insurance will not cover the procedure. However, the insurance carrier may cover all or a portion of the costs if medical conditions are correlated with excessive weight. For example, hernia is often present in panniculectomy patients. In this case, the insurance will often pay for the hernia repair, but not necessarily the panniculectomy. The doctor will help identify whether the panniculectomy is covered under your insurance plan.

Weight Loss Approaches

According to recent statistics from the Center for Disease Control and Prevention, approximately 65 percent of all U.S. citizens are overweight. Even worse, the organization has estimated that 30 percent, totaling over 60 million Americans, are obese. Many people are committed to fighting the battle. The Calorie Control Council estimates that there are 71 million dieting Americans — the highest figure in 15 years. The National Center for Chronic Disease Prevention and Health Promotion estimated that approximately 40 percent of U.S. adults get the recommended amount of daily activity.

For centuries, standard diet and exercise was the norm. Since that has changed in modern society, weight-related issues have become a priority in the health fields; obesity is better addressed, services are more easily accessible and whole wellness initiatives continue to rise.

The cause of excessive weight is no mystery. The effects of excessive weight are becoming painfully clear. In recent years, excessive weight has been more conclusively linked to many medical conditions, including increased risk of cardiovascular disease, stroke, high blood pressure, high cholesterol, diabetes and osteoporosis. Excessive weight can also be linked to psychological difficulties such as mood swings and lack of confidence. Proper diet and exercise can slow the aging process, improving skin tone or texture and reducing wrinkles. Weight loss is a multifaceted concern, meaning that it must be addressed in multiple ways, including

• regular physical examinations by a doctor
• body fitness assessments by fitness professionals
• diet-and-nutrition services, information online and bookstores

For the past half century, weight loss programs have evolved into an integrated strategy — a cooperative effort involving the consumer and the healthcare industry. According to MarketResearch.com, approximately 30 percent of women online are interested in losing weight. About 57 percent of American consumers are interested in buying and cooking healthier food. The employment outlook posted by the National Department of Labor indicates that the need for fitness and recreational workers will increase by 21 to 35 percent — an indication that more people are looking for the help of fitness experts.

People are beginning to benefit from advanced services provided by healthcare organizations, the food industry and health clubs. New multifaceted weight-control strategies are a positive trend for maintaining proper weight.

Services at a Glance

• Calorie Density Buzz: The North American Association for the Study of Obesity (NAASO) forecasted a calorie-density buzz for 2005. The idea behind calorie density is that if we replace high-calorie foods with more nutritious foods that are filling — while eating smaller portions of foods high in calories — we can reduce an average of 800 calories from our daily diet. The organization recently published a book entitled The Volumetrics Eating Plan: Techniques and Recipes for Feeling Fuller on Fewer Calories.
• Low-carb, high-protein has been the focus of restaurateurs who now offer more nutritional selections. Ruby Tuesday has launched many healthy choices on their menu as part of their Smart Eating Program. TGI Friday's has partnered with Atkins to produce appetizers and entrees. Chili's Restaurant is offering entrees with 15 carbs or less.
• Online dieting has become quite the craze as well. Websites such as caloriescount.com, jennycraig.com, a-personaldietitian.com, and dietwatch.com offer a new approach to dieting.
• Weight-loss frozen dinners and entrees dominate the supermarket retail sales category, according to MarketResearch.com.
• Health Clubs have integrated the services of personal trainers and nutritionists to meet the demand for an integrated weight-control approach. The American Council on Exercise offers a healthy recipe guide.
• Physician services to treat obesity is a growing trend. Bariatric physicians offer integrated and referral services for obesity treatment. Bariatric surgeons perform gastric bypass surgery as a last resort. Plastic surgeons perform liposuction, tummy tuck, panniculectomy and a host of other procedures to address difficult weight-loss issues. For issues of appearance, helpful cosmetic plastic surgery procedures also include neck-lift, facelift and eyelid surgery.

Why Do We Use These Services?

When it comes to diet and exercise, you'll need to set and achieve sub-goals towards the weight-level and appearance you want to achieve in your ultimate health-and-beauty goal. With a busy lifestyle, you'll want to keep the weight loss process as simple as possible. Below are the top 10 reasons for using the health industry's available weight-loss services.

1. To Obtain a Greater Quality of Life: Without question, proper diet and exercise lead to a greater quality of life.
2. To Live Longer: By maintaining proper diet and exercise, we reduce the risk of medical conditions and disease.
3. To Be Educated: Understanding the reasons behind diet and exercise.
4. To Be Motivated: Personal fitness trainers and dieticians offer motivation.
5. To Be Held Accountable: Instantaneous calculating, online recipes, personal trainers, dieticians, and regular doctor visits are all part of today's integrated approach.
6. To Prevent Injury and Medical Conditions: Proper diet and exercise is known to reduce the likelihood of injury and medical conditions.
7. To Heal Our Bodies: The right foods, with the right vitamins and minerals, along with exercise can offer tremendous healing benefits.
8. To Set Realistic Goals: With all of the information learning opportunities today, we can set realistic time frames to reach our goals.
9. To Have Easy Access: Restaurants with low carb-high protein offerings, growing numbers of personal trainers and a wealth of information on the Internet make the process easier than ever.
10. To Reach Goals in Half the Time: Constant motivation, accountability, reminders and better information help to reach goals in half the time.

Integrated Approaches with the Help of Professionals

For diet and exercise today, you can find support in many areas: restaurants, weight-loss professionals, doctors, health-club workers and healthcare organization leaders. It makes sense to seek help from a professional, just as you would for any important life-changing decision. You'll want to find the right professionals for your needs, who fit your lifestyle and our checkbook.

Understanding integrated services is important in today's world. Successful strategies may include a combination of plastic surgery procedures, skin treatments, diet-and-nutrition schedules, exercise regimen and an overall lifestyle shift as you assess your individualized health-and-beauty goals. Taking advantage of available services, and customizing them to your needs, is a big part of today's healthcare trends.